Lincoln Healthcare Group Limited is based in Newcastle and provides personal care and support to people living in their own homes. The service currently supported people living in Newcastle and North Tyneside but also covered Gateshead and Northumberland areas when required. At the time of our inspection there were 28 people using the service.

This inspection took place on 17, 19 and 23 October 2017 and was announced as we intended to visit people in their own homes and wanted to ensure management were present in the main office. We last inspected this service in July 2015, at which time we found them to be meeting all the regulations and rated the service as good overall.

The service had a registered manager who had been registered with the Care Quality Commission (CQC) since 2012. During the inspection we were informed that the current registered manager had changed roles within the organisation and intended to deregister. There was a new manager who was in the process of applying to the Commission to become registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that staff managed their medicines safely although procedures needed to be updated, including records kept. We have made a recommendation about this.

People told us they felt safe living at their homes with support from staff. Staff understood their responsibilities to report any safeguarding concerns to the manager. People and staff told us they felt there were enough staff employed at the service and we confirmed this through records.

Risks had been identified and measures put in place to minimise the risks to people and staff. Accidents and incidents were recorded and monitored.

People told us they were supported by staff to maintain their nutritional needs. Staff were trained and received support from the management team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People and their relatives knew how to complain if they felt this was necessary.

People were respected and their dignity was maintained. Staff displayed kind and caring attitudes and treated people as individuals. People’s care needs were detailed, recorded and reviewed by staff with input from people, relatives and other relevant individuals. The provider was in the process of reviewing its care recording procedures.

Staff told us they worked well as a team. They felt supported by the manager and the provider who staff said were approachable and made them feel valued.

Audits and checks of the service were in place to monitor the quality and safety of the service and the manager was in the process of reviewing their medicines audits and checks. Surveys were used to gather feedback from people about the service they received.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found-

Is the service safe?

We found that significant improvements had taken place in the recording of people’s prescribed medicines, and in the policies and procedures for administering such medicines. This meant that people’s medicines were now being safely administered.

Is the service effective?

We found that care workers were being given better guidance in their duties regarding recording and administering people’s prescribed medicines. Care workers told us the new systems were straightforward and clear, and that this allowed them to meet people’s needs effectively.

Is the service caring?

Care workers we spoke with were caring and compassionate when they talked about the people they supported. We found no evidence suggesting the service is anything other than caring towards the people it supports.

Is the service responsive?

We found the service had responded promptly and professionally to deficits identified at our last inspection. Improvements had been made within the timescale set down for action. Care workers we spoke with told us the office was responsive to any concerns or other issues they raised about people’s medicines and their care, generally. They told us the service incorporated their views, as well as the views of the person receiving care, in improving the way care was delivered.

Is the service well-led?

Staff spoke highly of the manager, and said she always took their views into consideration. Care workers told us they were now clear about their roles and responsibilities regarding assisting people with their prescribed medicines, and had been given improved guidance. They told us they knew they could always ring the office if they needed advice about any issues regarding people’s care. We found the manager was pro-active in seeking out new and improved guidance and documentation to support care workers in delivering good quality care.

People who used the service said they were pleased with the care and support provided by the care workers. Nothing was too much trouble for the care workers who were always polite and cheerful. They also said staff were kind and caring.

People said that they were asked about the help they needed when they started using the service and they were consulted about any changes in their care provision.

Comments included:

"It is an excellent service."

"I am perfectly happy with the care."

"I know who to contact if I have a problem."

"The carers are excellent."

"I am always told if there's a change in my regular carer."

" I find the carers flexible and they are very helpful and polite."

This inspection took place on 22 and 23 July 2015 and was unannounced.

We last inspected this service in May 2014. At that inspection we found the service was meeting all its legal requirements.

Lincoln Healthcare Group limited is a domiciliary care agency that provides personal care and associated domestic services predominantly to adults and older persons in their own homes. It does not provide nursing care.

The service had a registered manager who had been in post since December 2012. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were kept safe from harm. Staff had been trained in the recognition and reporting of abuse, and any suspicions of abuse were notified to the proper authorities. People told us they felt safe when with their workers.

Possible risks to the health and safety of people using the service were regularly assessed, and appropriate actions were taken to minimise any risks identified.

People were provided with sufficient staff hours to allow their care to be given in a safe and timely manner. Care was provided to the person by teams of support workers who had been trained in their individual needs. This allowed for consistent care to be given, even when some workers were unavailable.

New staff were vetted to make sure they were suitable to work with vulnerable people.

People were assisted to take their medicines safely by workers who had been appropriately trained.

There was a stable and experienced staff group, who had been given regular training and had the skills and knowledge needed to meet people’s needs. Staff were given the support they required to work effectively, and received regular supervision and work appraisal.

People’s rights under the Mental Capacity Act 2005 were understood by staff and were respected. The service worked with other professionals to protect those rights. People were asked to give their written agreement to their plan of care, and their consent was always requested before workers provided any care.

The nutritional needs of people using the service were assessed and appropriate support was given to enable them enjoy a good diet.

People told us their support workers were very kind and caring, and always treated them well. They said their privacy and dignity were respected by their workers, and they were encouraged to make their own choices and be as independent as possible.

People said they felt fully involved in how their care was assessed, planned and delivered. They told us they were given all the information they needed and were contacted regularly by the service to check they were satisfied with their service.

People were supported to follow their interests and be active members of their local community.

People said they were happy with the management of the service and felt listened to. Support workers were also very complimentary about how the service was managed. They said it was efficient and well organised, and that they were treated with respect.

Effective systems were in place to check the quality of the service being delivered.